Written Answers Nos. 252-269
252. Deputy Matt Carthy asked the Minister for Health the role Department of Agriculture, Food and the Marine veterinary officials play in meat processing plants with regard to Covid-19; and if he will make a statement on the matter. [39103/20]
View answerI would like to clarify that I have no function in relation to the Department of Agriculture, Food and the Marine's veterinary officials' role in meat processing plants, responsibility for which lies with the Minister for Agriculture, Food and the Marine.
253. Deputy Matt Carthy asked the Minister for Health if updates requested by the National Outbreak Control Team, NOCT, from the Netherlands and Germany regarding their Covid-19 outbreak investigations have been received; if he will provide such updates; and if he will make a statement on the matter. [39106/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
254. Deputy Matt Carthy asked the Minister for Health the additional resources taken since July 2020 to ensure it is always possible to convene an outbreak control team for each individual outbreak of Covid-19; and if he will make a statement on the matter. [39107/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
255. Deputy Matt Carthy asked the Minister for Health if there have been changes to the composition of outbreak control teams since July 2020 to ensure a broader multi-agency membership; the detail of such changes; and if he will make a statement on the matter. [39108/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
256. Deputy Matt Carthy asked the Minister for Health the number of unannounced HIQA inspections carried out in meat processing plants since July 2020; the locations and dates of these inspections; and if he will make a statement on the matter. [39109/20]
View answerThe Health Information and Quality Authority (HIQA) is an independent authority that exists to improve health and social care services for the people of Ireland.
HIQA does not carry out inspections of meat processing plants.
257. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding industrial action in University Hospital Kerry; and if he will make a statement on the matter. [39125/20]
View answerI have asked the HSE to respond directly to the Deputy on this operational matter.
258. Deputy David Cullinane asked the Minister for Health the reason the PCR testing for Covid-19 runs for between 40 and 45 amplification cycles when the general international consensus is 35; and if he will make a statement on the matter. [39127/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
259. Deputy John McGuinness asked the Minister for Health if he will investigate the reason a person (details supplied) was charged by a private ambulance company to be taken to hospital to attend appointments; the reason the public ambulance service failed to collect the person; if the charge will be paid by the HSE, given that the documentation states that the HSE and not the person availed of or booked the ambulance service; and if the matter will be expedited. [39131/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
260. Deputy Róisín Shortall asked the Minister for Health the number of alcohol-related cases, including blood alcohol poisoning and liver disease, that have presented to hospital in each of the past 12 months, in tabular form. [39147/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
261. Deputy Joe Carey asked the Minister for Health the progress that has been made to date to provide terminally ill medical cards; the outstanding elements of this process that need to be addressed to bring about the change as committed to in the Programme for Government; the time line for conclusion of the process; and if he will make a statement on the matter. [39149/20]
View answerUnder the Health Act 1970, eligibility for a medical card is based primarily on means. The issue of granting medical cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
The HSE has however a compassionate system in place for the provision of medical cards when it is informed that a patient is receiving end of life treatment – that is when patients’ unfortunately have a prognosis of less than 12 months. These applications do not require a means assessment nor are they reassessed. There are currently almost 1,800 such medical cards awarded. Separately, terminally ill patients who do not meet the end of life criteria may also qualify for a medical card under the general assessment processes. Every effort is made by the HSE, within the framework of the Health Act 1970, to support applicants in applying for a medical card and to take full account of the difficult circumstances, such as extra costs arising from an illness.
Furthermore, since 2015 medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer.
It should also be noted that the Programme for Government ‘Our Shared Future’ contains a commitment to extend discretionary medical cards to those with a terminal illness. A HSE Clinical Advisory Group (CAG) was established in December 2019 to review eligibility for medical cards in cases of terminal illness. The final Report of the CAG was recently submitted to my Department and has been published. The Report notes that there are practical and legal challenges with extending eligibility for medical cards for terminally ill patients within the framework of the current process.
However, I wish to assure the Deputy that I am committed to ensuring that terminally ill patients have access to the services they need. In that regard, my Department has devised a work programme which has been initiated and which will look to address the policy and legal findings of the Report and deliver on the Programme for Government commitment. This will include an examination within the next 12 weeks of potential options on a legislative framework to extend eligibility in such cases. In parallel to the legislative work, officials will also consider proposals that would enable those with a terminal illness to access services without necessarily requiring a medical card.
262. Deputy Róisín Shortall asked the Minister for Health the details of the approved level of legal fees contained within the figure of €1.433 billion approved for the National Paediatric Hospital Development Board; the status of the further request by the board for approval of legal fees estimated for 2020 to 2022 of €15 million; and if he will make a statement on the matter. [39159/20]
View answerThe NPHDB has the statutory responsibility and resources to plan, design, build, furnish and equip the new children’s hospital. The Government was advised in December 2018 that the overall cost to complete the new children’s hospital capital project is €1,433m.
A figure of €53 million was approved at that time for ‘other costs’. The ‘other costs’ includes NPHDB direct costs, Design Team fees & Specialist consultants comprising of legal, audit, procurement & independent conciliator.
The previous Government published a report of the escalation in national children's hospital costs in April 2019. The PwC report recommended that the NPHDB strengthen its project controls, including in respect of claims management. This has been done and the NPHDB has a robust process in place for the assessment of claims by the Contractor in accordance with the Construction Contract. The NPHDB has financed the implementation of the PwC recommendations, including strengthening claims defence, from within its resources, using its contingency fund.
263. Deputy Róisín Shortall asked the Minister for Health the current working assumptions of his Department in respect of the estimated completion date and final cost of the national paediatric hospital building project; the role of his Department in respect of cost containment on this project; and if he will make a statement on the matter. [39162/20]
View answerUnder the contract, the new children's hospital is due to be completed by the end of 2022 and handed over to Children's Health Ireland to open in 2023 after a period of commissioning. There will be delays associated with the requirement to cease works on the site of the new Children’s Hospital due to Covid-19 restrictions. As of March 2020, when the site closed due to Covid-19, the National Paediatric Hospital Development Board (NPHDB) was of the view that the Main Contractor was behind schedule on the construction works.
The current overall capital build cost of the project is €1,433bn. This includes all of the capital cost for the main hospital at St James's Hospital campus, the two Outpatient Department and urgent care centres at Connolly and Tallaght Hospital campuses, equipment for the three sites, and the construction of the carpark and retail spaces. The € 1.43bn figure on capital cost as set out above does not take account of the impact of COVID on the construction sector, including the NCH.
In addition to the capital project there is a broader programme of activity associated with the integration and transfer of the services of the three children’s hospitals to the new sites under development. The inclusion of these elements alongside the capital build account for a total overall project cost of €1.73 billion.
The PwC report makes clear that the Guaranteed Maximum Price established through the two-stage tender process does not provide a contractual ceiling on cost and significant residual risks remain of further cost.
The NPHDB is continuing to engage with the Main Contractor to obtain an updated programme of works that is in line with its contractual commitments. Any delivery outside of the timelines agreed under the contract could potentially be a matter for dispute resolution and it is not possible at this stage to forecast the cost implications as the position continues to unfold. At this point it is still too early to fully assess the time or costs impact of the pandemic on the project.
The NPHDB has statutory responsibility for planning, designing, building and equipping the new children's hospital. There are Governance structures in place to oversee and monitor progress on the Children’s Hospital Project and Programme. These include the Children's Hospital Project and Programme Board, chaired by the Secretary General of the Department of Health, and the Children’s Hospital Project and Programme Steering Group, chaired by the Deputy Director General of the Health Service Executive. The Steering Group directs the overall programme of work within agreed parameters, and reports to the Children’s Hospital Project and Programme Board.
264. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to reports that patients requiring mental health treatment in St. Vincent’s University Hospital, Dublin, are being asked to wait outside the hospital with no shelter; if he has engaged with the hospital on this issue; the steps his Department is taking to address this practice; and if he will make a statement on the matter. [39176/20]
View answerAs this is a service matter, I have asked Health Service Executive to respond directly to the Deputy as soon as possible.
265. Deputy Brendan Smith asked the Minister for Health when a project (details supplied) at a healthcare facility will proceed to the next stage; and if he will make a statement on the matter. [39177/20]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to the deputy directly in relation to this matter.
266. Deputy Sean Sherlock asked the Minister for Health his views on a cost-saving issue (details supplied) implemented by the HSE. [39178/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
267. Deputy Ged Nash asked the Minister for Health the criteria that have to be met for HIQA to become concerned about the welfare of residents in a nursing home; and in cases in which HIQA has concerns, the steps it takes; and if he will make a statement on the matter. [39247/20]
View answerThe Chief Inspector of Social Services takes a risk-based approach to regulation which means that decisions are based on the information about the centre. Regulatory activities are prioritised and resources are organised to ensure monitoring, inspection and enforcement are based on the assessment of the risk that the regulated service poses. In deciding the most appropriate regulatory response, the Chief Inspector’s main focus is to ensure the safety of residents and bring about compliance.
There are a number of options available to the Chief Inspector and these include:
- Escalated regulatory activity options such as:
- a risk-based inspection
- seeking further information such as a compliance plan update or assurance report
- provider meeting
- warning letter
- asking the provider for information under the Chief Inspector’s statutory powers under section 65 of the Act
- reassessing the fitness of the provider or persons participating in the management of the designated centre.
Statutory enforcement options such as:
- refuse to register or renew the registration of a designated centre
- vary or remove a centre’s condition of registration
- attach an additional condition of registration
- cancel a centre’s registration
- urgent application to the district court (with or without notice to the provider) to cancel registration or vary, remove or attach additional conditions of registration.
268. Deputy Ged Nash asked the Minister for Health if the late submission of NF01 and NF02 forms to HIQA is a matter that affects the registration of a provider; the consequence if a centre does not submit the forms in a timely manner; if registration and re-registration is possible if forms are not submitted in a timely manner; if, in April 2020, a nursing home (details supplied) submitted all forms in a timely manner; and if not, the action that was taken; and if he will make a statement on the matter. [39248/20]
View answerNotifiable events are a regulatory requirement and these include notification of a sudden death (NF01) and an outbreak of an infectious disease (NF02) among others. A proportionate approach is taken when providers do not comply with their regulatory requirements. When other means of ensuring sustained compliance with the regulations and standards have failed, such as implementation of a compliance plan (action plan), a cautionary or warning meeting with providers or a warning letter, enforcement action may be taken.
Compliance with all regulations is one aspect of the decision-making process to register or renew the registration of a centre. The fitness of the registered provider and other persons participating in the management of the centre must also be taken into account.
An inspection of the nursing home in question found it to be substantially compliant in regards to the notification of incidents. While the Chief Inspector of Social Services was satisfied that most matters requiring notification had been appropriately notified, during the outbreak, there had been delays in notification. In response to these delays, an action plan has been completed. Full details can be found in the inspection report from May 2020 which is available on the HIQA website.
269. Deputy Ged Nash asked the Minister for Health if a HIQA inspector informed a nursing home (details supplied) on 8 May 2020 that an independent inquiry was not appropriate, as it would be inspected as normal; and if he will make a statement on the matter. [39249/20]
View answerThe Chief Inspector of Social Services within the Health Information and Quality Authority (HIQA) is the statutory independent regulator for the nursing home sector. The regulatory regime of registration and inspection holds the registered provider to account for the service they provide.
The Health Act 2007 as amended gives the Chief Inspector statutory powers to take action where a registered provider fails to comply with their statutory obligations under the Act and regulations. These powers include:
- refuse to register or renew the registration of a designated centre
- vary or remove a centre’s condition of registration
- attach an additional condition of registration
- cancel a centre’s registration
- urgent application to the district court (with or without notice to the provider) to cancel registration or vary, remove or attach additional conditions of registration.
- The Chief Inspector carries out a number of regulatory activities to assess a provider’s compliance, which include:
-desktop inspection of information received
- on-site inspection in designated centres
- ongoing assessment of compliance by centres with the regulations and national standards.
Inspection reports are published on HIQA’s website, including the most recent undertaken in relation to the nursing home referred to by the Deputy. The Minister would not have information on discussions that may have taken place within this context.
